Michael Steele Doesn't Know What Health Insurance He Has

On some level, John McCain's confusion over the number of houses he owned was understandable. It actually turned out to be fairly hard to figure out how many houses he owned. Some were split into parts. Most were under his wife's name. Many were part of trusts and investment shells constructed for opaque purposes. But I have a really hard time understanding how RNC Chairman Michael Steele has managed not to notice which insurance company provides coverage to him and his family:

With Congress and the White House squabbling over health care reform, Republican National Committee Chairman Michael Steele said on Tuesday he’s not really sure which insurance company covers him.

In fact, two sources say it’s Cigna that provides the RNC health coverage.

“I haven’t had to use the plan too much, thank goodness – although there are days on this job,” Steele said.

An RNC spokeswoman declined to comment.

There's something oddly poignant about that last line. I imagine Steele's spokespeople have pretty much given up on life at this point. But there's an actual policy insight here: Steele didn't shop around for health-care insurance. Tthe RNC didn't give him a choice of plans. Cigna appears to be their exclusive provider. Michael Steele talks a good game about choice and consumers and the importance of private markets. But the status quo doesn't give him, or the rest of us, access to any of that. The Health Insurance Exchange in Obama's proposal would.

We've hit a weird point in American politics when Henry Waxman is more interested in a functioning marketplace than Michael Steele.

Ezra - could you PLEASE do me a huge favor - could you PLEASE explain how the proposed exchange differs from our ability to log onto e-surance websites and get different quotes from different insurance companies? We can do that today - but it doesn't make me a savvier consumer. Because the moment I sign up for one, they'll send out the forms and I'll be rated for age, or illness, or whatever.

There is "choice" out there today - but it is false choice. How does the exchange transform today's choice into real and affordable alternatives? Could you devote a post to the nuts and bolts of the exchange? I know you've posted on it before, but without the kind of details I'd like to see.

-- But the status quo doesn't give him, or the rest of us, access to any of that. The Health Insurance Exchange in Obama's proposal would.-

Not according to the House bill. Only some of us will be allowed into the Exchage and not until 2013. The rest of us will be in group plans, provided by our employers. That changes if a study released by the Commissioner in 2015 concludes that the access to the exchanges needs to be expanded.

Who are the people arguing against a heath insurance exchange? I mean it seems like a free market kind of solution- I don't really get who would be voting against it if the Dems put out that as a standalone proposal right now then where would the opposition come from?

Also, by his own account (during his '06 Senate campaign), Steele didn't have any health insurance for about three years, when he was a self-employed consultant. He told his kids "don't break anything, because Daddy can’t afford to fix it." (Quoted in a Post article in Oct. 2006)

-- Who are the people arguing against a heath insurance exchange? I mean it seems like a free market kind of solution- I don't really get who would be voting against it if the Dems put out that as a standalone proposal right now then where would the opposition come from? --

They don't want a public health insurance plan option to be part of the Exchange and they seem to want the Exchanges to be local, not national.

I fully understand the opposition to a public plan- based on the details that could be a disaster. But the health insurance exchange itself would sure seem like a pretty politically popular idea with republicans. Thats clearly interstate commerce so I don't see why that would have to be a state issue. Insurance companies I am sure would love to see barriers to crossing state lines taken down. People would like it because it gives them more option. There is nothing about a health insurance exchange that requires there be a public plan at all.

"Who are the people arguing against a heath insurance exchange?"
Me. I actually think it's an interesting idea, but I want to get cheaper, high-deductible, catastrophic style insurance. In reality, what most people are shopping for is the way to get as much care as possible for the lowest price, which is how we end up with insanities like the plan with low co-pays that caps reimbursement for major procedures at $10,000. The biggest problem with the states right now are the minimum requirements that they put on the plans make them more expensive.

If we simply make employer paid benefits taxable, health insurance will be more like auto insurance, where the individual market is more open. This will also make consumers more price sensitive to the cost of health care. If we favor high deductible insurance, there will be more price sensitivity on the cost of individual procedures, and we will see price innovation.